Another British Healthcare Horror Story, but It’s “False” According to Paul Krugman

Paul Krugman assured us back in 2009 that, “In Britain, the government itself runs the hospitals and employs the doctors. We’ve all heard scare stories about how that works in practice; these stories are false.”

An elderly woman died alone after doctors failed to tell relatives they were ending her life on the controversial Liverpool Care Pathway. Olive Goom, 85, passed away with no one by her side after medics neglected to consult with her family about her treatment at Chelsea and Westminster Hospital. …As Miss Goom lay dying alone, staff reassured relatives on the phone just hours before her death that there was no urgent need to visit – even though doctors had already removed tubes providing vital food and fluids. Her family discovered that she had died only when her niece went to visit her and found she was already being prepared for the mortuary. They said last night that they will never be able to stop feeling guilty that no one was there in her final hours. The Mail has been contacted by several families who claim that relatives were put on the Liverpool Care Pathway – the controversial system designed to ease the suffering of the dying in their final hours – without any consultation. Some said they found out that their relatives were on the pathway only after they happened to read their medical notes; and by that time it was too late.

Keep in mind, by the way, that the Liverpool Care Pathway is sort of akin to the IPAB “death panel” in Obamacare.

Defenders of government-run healthcare say that’s nonsense and assert that there won’t be any rationing, denial of care, or requirements for euthanasia. That’s technically true, but the Obamacare death panel will be determining what’s an acceptable treatment and what’s the government-approved payment schedule.

Crushed by Obamacare?

So it’s sort of like holding a rock in your hand, standing over a kitten, letting go of the rock, watching it hit the kitten, but then claiming that you did nothing wrong because gravity caused the rock to fall.

Okay, that’s a morbid example, but you get the point. And my concern isn’t that rationing only exists with a government-run system. Any healthcare system will involve rationing. The real issue is whether individuals are part of a free society so they can make the choice of how to ration.

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In the absence of facts from the hospital, together with the fact that the Daily Mail provides some of the most sensationalist headlines – (hence why it is the most visited online media in the UK) – I would advise caution in any conclusions you might reach.

How hard is for people to understand that the guiding principle is going to be: “The Needs of the Many, Not the Needs of the Few or the One”?

Yeah, Captain Spock said that in the second Star Trek film. That’s still the easiest way to sum up what IPAB is going to be doing. Stark utilitarianism like that is not exactly easy to cope with on a mass social level…

Did you actually read the article from the Daily Mail? A spokeswoman for the hospital admitted that they did, in fact, put the woman on the pathway procedure without advising her family. Additionally, the health secretary Andy Burnham called for an urgent review of the pathway operations.

The real difference is if rationing is roughly equal for all, or if those that have money get everything and those that do not get nothing.
The fact that every other rich country, including Britain with is NHS, get better results with less spending shows who is right, at least in terms of reaching a given good (more healthy and long-living people).

“Doctors found that people who have treatment here [UK NHS] are four times more likely to die than US citizens undergoing similar operations. The most seriously ill NHS patients were seven times more likely to die [in the UK NHS] than their American counterparts.”

There are 4 private for profit hospitals in London run by HCA an American owned ‘health’ company found guilty of carrying out numerous unnecessary medical procedures just to make a buck. HCA has been fined millions of dollars and there are further suits outstanding. No part of the British National Health Service has ever committed this appalling crime. Old people die alone all over the world regardless of who or how medical staff get paid. This attack on Obama health is as baseless as it is contemptible.

“The needs of the many outweigh the needs of the few.” It sounds so nice and so altruistic and so noble. The problem here and what a great many people miss when they use it to defend things like government ordered rationing of a system is that Spock freely chose to sacrifice himself. That doesn’t make the statement less true, but let’s examine how Kirk might have made that call. Do you honestly think he would have sent Spock in there, or would he gone himself? How many red shirts would have died that day to save the ship?

Spock represents the free society in that he was able to make his own choice and freely, rationally give himself up to save the rest. Kirk would have done the government thing and might have sent lowly ensign after ensign in there, or worse, not sent anyone at all sacrificing everyone. Which method is the more efficient one to achieve the best result? Clearly, it was allowing Spock to choose to sacrifice himself rather than remove the choice from his own hands.

That’s the choice we face. Do we allow a system where individuals have some say in how they make their own health care choices, or are they removed entirely from the process in favor of a group like IPAB or NHS who makes the decision for all? Which do you think will end up making more efficient decisions in the end? Consider that NHS has more employees than the US has soldiers in its military before you make that answer.

Poppycock! How many examples of similar screw-ups by US healthcare providers have been reported (and how many not). The simple fact is that single-payer insurance is the only way that we can hope to deliver a reasonable standard of healthcare to the most people. Stuff happens, but overall the UK provides better outcomes at lower cost than the US.

What does that tragic mistake by hospital workers have to do with who runs the facility? You do not really want to tells us that people in for profit clinics never do wrong?

And you can’t have it both ways. Something has to give. Either you want cheaper health care, then some services have to go. Or you want every citizen to be treated with the best possible medicince, then prepare for high cost. So most nations here in Europe compromise: they offer basic services for all and subsidize it if necessary. What we don’t have is a status of “uninsured”. And this is what Obamacare does: (almost) no more “uninsured”. Obamacare will give millions of Americans health insurance. Welcome to the civilized world.

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And the Labour party used similar horror stories and scare tactics during the campaign to implement the NHS; all of these are, of course, anecdotal. The fact of the matter is that the United States has a lower life expectancy than most industrialized nations, and this is in no small part attributable to the fact that the US is the only advanced nation with a large population of uninsured citizens (around 60 million, a nation about the size of France). This despite that we spend FAR more on healthcare per-capita than any other nation.

I agree that the IPAB should be abolished, and that faceless, unelected technocrats should never be in a position to make life-and-death decisions vis-a-vis cost effectiveness. However, reactionaries’ insistence that Obamacare (itself a policy creation of that noted bastion of leftist thought, the Heritage Foundation – wink wink) be repealed while offering no credible solutions to the market failures distinct to individual health insurance (i.e., insurance companies cherry-picking their customers and denying coverage to those with preexisting conditions), adds nothing to the debate.

Hey. we have that here. My mom was starved for a bit more than a week with no permission. She was left without treatment for a broken back for a week and when cancer was found, the hospital covered it up — it was found at the place she was sent to — but by then it was too late. Medicare officials were notified of the starvation, came, verified, and left Mom there — and with the paraplegia, we could not get her out.

I suppose there are two egregious errors here: 1. The Obamacare “death panel” has no actual authority, serving only an advisory role. It can’t impose anything on anyone. The “death panel” claim has been debunked to, well, death. 2. You haven’t explained why this could happen in the English system but not the American one. A private hospital could make the identical mistake, so why would a private insurance system somehow prevent this? Even if it could, is this one mistake compensation for the millions who go bankrupt in the American model? I’m not so sure.

But the way this article connects the dots, if a kitten gets run over in England you’ll surely blame it on the parliamentary system.

From separate posts: “The real difference is if rationing is roughly equal for all,..” “The simple fact is that single-payer insurance is the only way that we can hope to deliver a reasonable standard of healthcare to the most people.”

Let’s first observe that at least some single payer advocates admit they can only achieve their goals through government prescribed rationing. Second, if you walk the streets in the U.S. tonight you will not see children and little old ladies dying in those streets because they couldn’t get a simple antibiotic or insulin.

“Uninsured” does not equal “no healthcare”. Those not covered by Medicaid or Medicare (rationed via fixed government reimbursements which often do not cover real costs, thus more doctors refusing to provide these services) will be covered when they walk in a hospital or clinic. They cannot be denied by law. We don’t have a coverage problem we have a cost problem, predominantly because people are seperated from pricing decisions.

As to the second statement of “delivering a reasonable standard of healthcare”, what is reasonable? The history of socialism is that for any service, product or commodity, because a single payer or planned market cannot pull everyone up to the average condition of a free market, they lower it for all in the name of egalitarianism. Except of course for those with the political connections or the money to get around it. Yes, in France and the UK as well.

To those who say that such problems could occur in a private health care system too, may I point out the rather obvious difference: Under a private system, if I don’t like the health care that I or my relatives are getting, I can switch to a different insurance company or to a different hospital that has different policies and stanards. Under a government-run system, there is no choice. If I don’t like how the government runs the system, well that’s just too bad. Not only does such choice mean that I can leave a bad provider and try to find a better one, but it also means that the providers know that, so they have an incentive to provide quality service. This is Economics 101 folks: competition. It’s why you get much better service at the local department store than you do at the motor vehicle bureau.

How could there possibly NOT be death panels under a government-run health care system?

Suppose that, under the utopian government-run system of the future, someone shows up at a hospital and announces that he wants a heart transplant. Will the staff just automatically give him one, no questions asked? Or will they insist on an examination to determine if he has any need for a heart transplant, and how his need compares to the needs of other patients? No resource is infinite. There are only so many doctors, so many available organs for transplant, so many time slots available on the CAT scan machine, etc etc. Someone has to decide who gets what, when, and how much.

Under a government system, that “someone” is going to have to be government committees. Those committees may try to establish objective criteria and impose them evenly across the board, with the obvious problem that people do not always fit into nice neat categories; or they may consider patients on a case by case basis, with the obvious problem of bias and favoritism. Either way, government committees will decide, directly or indirectly, who lives and who dies.

Under a private system, somebody still has to decide who gets care. But there are many somebodies. If hospital #1 won’t help you, you can go to hospital #2. You can, ultimately, get any medical care that you are willing and able to pay for, or that charities are willing to provide. Does this mean that the rich and powerful get better care than the poor? Of course.

But really, does anyone out there honestly, sincerely believe that under a government-run health care system, when there’s only one kidney available for transplant, and two people who need it, one a homeless beggar, and the other the Senate majority leader, that it will go to the beggar and the Senator will be left to die? Do I need to tell you anything else about the two patients for you to guess which will get the kidney?

It’s not a question of whether the rich and powerful will get better care under one system or the other. Surprise: the rich and powerful will get better care under any system, because by definition the rich and powerful control the system. The question is what choices the people at the bottom have. Under a private system, we little folk still have choices. Under a government system, we don’t.

How is a government death panel any different than an insurance death panel? I cant tell you how many times I’ve read of ins.companies claiming a life saving procedure thats been used with good results is “experimental” or refusing to cover an alternative medication to avoid covering it, even when doctors stated that medication would kill the patient due to some abnormality. I have always been at the mercy of using whatever coverage a particular job at the time had us pay into. This is true for every person I know. Thats how it is for most people since cost is lower due to the volume of policies an employer has.

@Guido
You state that other countries get better results…no, as a matter of fact, they don’t. You undoubtedly are relying on that oft cited but ludicrous study published by WHO which is based on on research done by the Commonweatlh Fund.

In their study (which placed the US 27th) they measured 11 criteria, NONE OF WHICH WERE MEDICAL OUTCOMES FOR DISEASE. Odd, don’t you think?

When you look at actual outcomes for the 10 worst maladies, e.g. heart disease, cancers of various kinds, diabetes, etc., the US is #1 in outcomes in 8 and #2 in the other two.

The VAST majority of our problems come from lifestyle issues, NOT medical care. We’re fat, lazy, eat crappy food, don’t exercise, and smoke and drink too much. And we STILL rank in the top in life expectancy when you eliminate accidents and murder.

Last time I checked the wonderful government run health plans excelled in another area: child birth. Of course they don’t bother to mention that in the USA attempts are regularly made to save prematurely born infants (up to several months early). Under the government systems they are considered non-cost effective. God help your child if they are born two months early in Europe, because the government isn’t likely to.

There would be no need for Obamacare if his health plan is to reduce costs and give everyone access to healthcare, as he says. Obama bragged about his plan says you cannot be turned down for pre-existing conditions and everyone says ,’Obama is looking out for us.’. What you don’t know is he has in his plan his panel who will decide ‘what is medically necessary’ or what you would call rationing. You will not know if you are being rationed, you will be told by the healthcare provider,’ We are sorry, his/her condition is poor and nothing we can do. You trust the healthcare provider and you take their word for it, when in fact obamacare’s panel says they won’t pay. You voted for this so good luck.

[…] Let’s close by reminding ourselves that Paul Krugman infamously wrote that, “In Britain, the government itself runs the hospitals and employs the doctors. We’ve all heard scare stories about how that works in practice; these stories are false.” The news report you just watched suggests that he’s putting ideology above evidence. And if you want more data (some of it very distressing and tragic), you can click here. […]

I have HUGE doubts about Obamacare and the inevitable single payer system it was designed to become. I’ve begun to see the effects of it already. I had always been extremely healthy my entire life, skiing, playing racquetball, tennis, etc. Never smoked, drank or did drugs.
However, in the last two years I have acquired 5 different autoimmune diseases that will, no doubt, leave me crippled with deformities in both legs, a fused spine and hips, other joint deformities and completely blind without my medications and definitely my infusions. tLuckily I have had great insurance through my husbands company that has covered literally everything I have needed so far. Doctors, procedures, infusions, and prescriptions. Alas, no more at the beginning of the year. Like UPS, my husband’s company will be dropping spouses who have the ability to have insurance through their work or elsewhere. Since I do have Medicare Part A (hospitalization only) from my disabilities, I will be forced to purchase the rest of the Medicare plan, which in essence IS, or will be Obamacare soon enough. My doctors know what lies ahead with the Obama plan and they know my plight, obviously. They have forwarned me that I will not be able to keep the same medicines that I am currently receiving due to the high costs and my age, I’m 55. They did say they will do anything they can, with less effective meds however to keep me as well as they can.
Yep, that Obamacare fiasco is going to work super, duper, peachy for me! I’m sure I won’t be dancing, let alone seeing, my grandkids grow up.

[…] Except now the fat cats lining up at the Treasury door are the big health insurance corporate titans. They got in bed with the White House to push Obamacare and now they’re worried about losing money now that it’s becoming more apparent that the American version of government-run healthcare doesn’t work any better than the British version. […]

[…] Except now the fat cats lining up at the Treasury door are the big health insurance corporate titans. They got in bed with the White House to push Obamacare and now they’re worried about losing money now that it’s becoming more apparent that the American version of government-run healthcare doesn’t work any better than the British version. […]

[…] already have a very long list of mistakes (see here, here, here, here, here, here, here, here, and here for a few examples), then why not go for the gold and try to give Keynes credit for the supply-side […]

[…] already have a very long list of mistakes (see here, here, here, here, here, here, here, here, and here for a few examples), then why not go for the gold and try to give Keynes credit for the supply-side […]

[…] When I write about columns in the New York Times, I’m normally pointing out silly examples of bias or exposing absurd mistakes (with Paul Krugman deserving his own special category for sloppiness, as seen here, here, here, here, here, here, here, here, here, here, here, and here). […]